- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,421.40 / $20,776.09 / $23,511.50
| Facility | | $13,421.40 | $20,776.09 | $23,511.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,879.20 / $19,479.41 / $26,791.42
| Facility | | $12,879.20 | $19,479.41 | $26,791.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,393.73 / $19,124.84 / $29,200.52
| Facility | | $12,393.73 | $19,124.84 | $29,200.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,706.00 / $19,439.00 / $26,741.00
| Facility | | $12,706.00 | $19,439.00 | $26,741.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $24,011.58 / $31,957.48
| Facility | | $5,274.00 | $24,011.58 | $31,957.48 |